Why are Medical Professionals who Deliver Babies in Hospitals Choosing to have their Own Babies at Home?

Trending Among American Doctors: Obstetricians, Labor Nurses, and Other Medical Professionals Choosing to Have Their Babies at Home

Jennifer Margulis Special to Health Impact News

It used to be one of the best-kept secrets in the medical profession.

Doctors, when they talked openly about it, were met with raised eyebrows and worried looks.

They were ridiculed by their colleagues, lost professional standing, and were sometimes even browbeaten into leaving their jobs.

But now an increasing number of doctors, labor and delivery nurses, certified nurse midwives, physician assistants, and other medical professionals are choosing to birth their babies at home.

And these doctors and other medical professionals are talking more openly about having home births than they ever have before.

“We’ve had countless midwives who work in hospitals deliver with us, a number of labor and delivery nurses, a neuroscientist, a pediatric oncologist, two pediatricians, medical residents planning to specialize in obstetrics, and at least one family practice doc,” says Mairi Breen Rothman, a certified nurse midwife based in suburban Maryland who sits on the board of the American College of Nurse-Midwives. Rothman birthed two of her four children at home. “They are definitely being more open about it … Home birth has become a more acceptable form of care.”

Home Births Increasing in the U.S.

According to the National Center for Health Statistics, in the last ten years the home birth trend has taken off, increasing by 29% between 2004 and 2009 and continuing to rise. While fewer than 2% of all births in the United States take place at home, in 2012 some 53,635 births took place out of the hospital (35,184 home births and 15,577 birthing center births), the highest numbers since 1975.

Though we don’t know the exact numbers of medical professionals choosing home birth, this new home birth trend tends to be a largely upper middle class non-Hispanic white phenomenon popular in places like Portland, Oregon, Park Slope, Brooklyn, and the state of Vermont (where insurance companies are required by law to pay for it). This trend includes hundreds, if not thousands, of doctors and other health care professionals.

Just ask Jenny Fish, M.D., and her husband Jimmy Wu, M.D., who are both family physicians. Dr. Fish gave birth to their daughter, Kailani, seven months ago in a rented birthing tub under big bay windows in the couple’s living room. Though neither would have even considered home birth when they began their medical school residency, by the time they both started practicing in 2012, they had five friends, all M.D.’s, who delivered their babies at home.

“We live in a very home birth friendly community,” says Dr. Fish of northern California. “None of our colleagues looked at us strangely because so many people are doing it. But my best friend is a high-risk OB in Minnesota. The idea that we had a home birth still freaks her out.”

Or talk to nurse practitioner Jessicca Moore, a Petaluma-based mother of two who chose to birth both her children at home. Moore knows over 50 doctors, nurses, and hospital midwives who had home births in her area alone. And eleven days ago she successfully raised $89,186 (over $3,000 more than the goal) from 960 Kickstarter backers to produce a documentary film called, “Why Not Home?” which will feature dozens of doctors, nurses, and midwives who have chosen to birth at home.

Why are Parents Choosing to Birth at Home?

One reason is America’s C-section rate, which has increased dramatically—about 60 percent—between 1996 and 2009 and remains dangerously high. Nearly a third of all births in the United States (32.7 percent in 2012) are via Cesarean section.

Pregnant women who want to avoid surgical birth know they have to avoid the hospital.

They also don’t want what happened to Donna Sills to happen to them.

A 33-year-old mother of two, Donna Sills was in active labor at The Outer Banks Hospital in Nags Head, North Carolina when Dr. Timothy Kling, M.D., stormed into the room and shouted, “WHAT’S YOUR PROBLEM?”

“I’m trying to have a baby,” Sills, surrounded by friends and family, answered, “What’s yours?”

Dr. Kling was angry because Sills refused to sign the hospital’s consent to surgery form because she did not want another C-section (having had two already). Although a comprehensive literature review published in the British Journal of Obstetrics and Gynecology in 2009 found that vaginal birth after two cesareans has a 71 percent success rate and low risks of complications, VBAC was against the hospital’s policy. In active labor and nearly four centimeters dilated, Sills was dismissed from the hospital. She and her support team drove to what was then called Albemarle Hospital in Elizabeth City, North Carolina. Although Albemarle admitted her, Sills was told by the doctor on call that he would not allow a VBAC because he had not followed her care.

Having contractions every five minutes apart and now in a lot of pain, Sills continued to refuse a C-section. At a standstill, the hospital called an ambulance, placing Sills’ discharge papers on top of her abdomen as she was being strapped to the ambulance gurney. Sills was taken by ambulance over the state border to Sentara Norfolk General Hospital in Norfolk, Virginia (where she was treated with respect and compassion by the resident on-call, Dr. Courtney Angell, M.D. Sills gave birth vaginally about nine and a half hours later to a healthy baby boy).

Although the care a laboring woman receives varies greatly depending on the hospital, the labor and delivery nurses who attend her, her obstetrician’s philosophy about birth, bedside manner, and availability, and even what kind of insurance she has, bullying, emotional abuse, and being denied choices during birth are considered acceptable practices in hospitals across the United States.

“Women are having their bodies completely hijacked,” says Dr. Jennifer Lang, M.D., a 38-year-old board certified ob-gyn based in southern California who specializes in complex gynecologic surgery and has attended over 1,000 births. Although Dr. Lang gave birth to her first child at Cedars-Sinai Medical Center in Los Angeles, California, she chose to have her subsequent children at home.

“I know all about hospitals and all the things that go on there,” says Dr. Lang. “The more you look critically, the more nonsense you see.”

Why did Dr. Lang herself choose home birth? Although with her firstborn she had a peaceful, unmedicated hospital birth, she actually felt safer birthing at home.

“I’m among the most educated on this issue; I’ve done three years of extra surgical training on top of four years of delivering babies,” Lang says. “For me I felt home was the safest place to have my children. I did a calculated risk-benefit analysis. I knew that my exposure to risk by participating in some of the medical interventions would be higher. If you look at almost every obstetric outcome, it is more dangerous to give birth in the hospital. Babies have bad outcomes in the hospital all the time and a lot of the bad outcomes come when we have done too much obstetrical intervention, like exhausting the baby by hyper-stimulating the uterus.”

Angela Dodge – Labor and Delivery Nurse

Two years ago Angela Dodge, a 27-year-old labor and delivery nurse from Delavan, Wisconsin, chose to have a home birth with her first child.

“After a lot of research and time working in the hospital I realized that I felt safer delivering at home without the time constraints and medical equipment restrictions like continuous fetal monitoring,” Dodge explains in an email.

Continuous fetal monitoring, though the norm in most American hospitals, has been repeatedly shown to increase the likelihood of C-section and instrumental birth without improving fetal outcomes. Hospitals in Scandinavia, where the infant and maternal mortality rates are much lower than in the United States, have discontinued its use.

Though Wisconsin is a state with one of the highest home birth rates (between 1.5–2.59%, according to the CDC), some of Dodge’s colleagues were hostile about her choice.

“They said things like, ‘I thought you were smarter than that, being a nurse,’ or ‘you’ll be lucky to survive.’ I had an M.D. yell at me at the nurses’ station about how studies show infant mortality with home births is higher and only irresponsible people choose to do such a thing,” Dodge recalls.

Dodge was in labor with her son for three days. “It was the hardest thing I have ever done and I wouldn’t do it any other way,” she says. “It was life changing.”

Her successful home birth also had a positive effect on her colleagues.

“After I successfully birthed my son at home and survived—haha—people’s attitudes changed. The women I worked with started to view the natural option, even in the hospital, through a different lens, and noticed how successful and usually shorter the natural births were. They, as people often do, just feared the unknown.”

Jenny Fish, M.D., and Husband Jimmy Wu, M.D. – Family Physicians

In her current practice in Santa Rosa, California, Dr. Fish delivers about 45 babies a year in the hospital, but she says she knew she would be safer and healthier if she had her own baby at home.

“In residency I witnessed complications that we doctors cause. There were so many,” Dr. Fish explains as her pudgy 7-month-old daughter Kailani gums her shoulder.

So instead of rushing off to the hospital, Dr. Fish spent the beginning of her labor in the claw-foot tub in her bathroom while her husband set up a rented birthing tub in their living room. Her mother had Cesarean births but Dr. Fish had no problems at all. Her labor happened fast, lasting only four hours.

“I tell people it was good we prepared for a home birth, because we probably would have had one anyway,” says Dr. Fish. “I had planned to labor at home as long as I could. There was no way we would have made it to the hospital.”

Tara Elrod and Glen Elrod, M.D. – Ob-gyn

When Tara Elrod first started feeling contractions she was on the third floor of her home in Wasilla, Alaska. It was the middle of September and bright sunshine streamed through the window. Elrod, then 29 years old, held onto the windowsill and breathed. When the contraction was over, she waddled into the bathroom to do her make-up, putting mascara on her right eye. She stopped to lean over the sink for another contraction. “I knew we were going to have lots of pictures,” Elrod remembers with a laugh. “My husband’s a photographer.”

Tara Elrod’s husband, Glen Elrod, M.D., is also an ob-gyn with a thriving practice.

Why were the Elrods having their first baby together (each have children from previous marriages) at home? Because they saw no reason to go to the hospital.

“Yes, birth can have complications, birth can go wrong, C-sections are needed, moms do hemorrhage,” Dr. Elrod, who has attended over 2000 births and nearly a hundred out-of-hospital births, concedes.

“But if doctors could step back they would see that the vast majority of these complications happen because of things that are done to the mothers in the process of giving birth in the hospital. When you take away medicinal pain relief, epidurals, restriction of food and water, staff coming in and out of the room, and routine vaginal exams while women are in active labor, you can significantly reduce the complications that are caused by the interventions themselves. Moms do better without unnecessary interventions than they do when they’re overly managed.”

Glen and Tara Elrod’s daughter Aria was born just after 11 p.m. that evening, three years ago. And just last month the Elrods welcomed another baby into their lives. A boy this time. Also born at home.

“If you’re low-risk and healthy and have a healthy pregnancy you don’t need the hospital,” Tara Elrod, who is a certified direct-entry midwife, insists. “It’s a no brainer.”

About the Author

Jennifer Margulis, Ph.D., former Senior Fellow at the Schuster Institute for Investigative Journalism at Brandeis University, is an award-winning travel, culture, and parenting writer. Her writing has appeared in many of the nation’s most respected and credible publications, including the New York Times, the Washington Post, and on the cover of Smithsonian Magazine. A meticulous researcher who’s not afraid to be controversial, she is nationally known as a journalist who opens people’s eyes to the realities behind accepted practices in the care of children.